Clinical Characteristics of Patients with Untreated Achalasia.

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Clinical Characteristics of Patients with Untreated Achalasia.

J Neurogastroenterol Motil. 2017 Mar 28;:

Authors: Jeon HH, Kim JH, Youn YH, Park H, Conklin JL

Abstract
Background/Aims: Patients with untreated achalasia frequently complain of heartburn and regurgitation. The diagnosis of achalasia might be delayed because these symptoms are misinterpreted as gastroesophageal reflux. We aim to evaluate the clinical presentation, radiologic, and manometric findings in patient untreated achalasia.
Methods: The records of patients diagnosed with primary achalasia between July 2004 and January 2012 at Gangnam Severance Hospital, Seoul, Korea were evaluated. We reviewed their clinical history and the results of barium esophagogram, endoscopy, and esophageal transit scintigraphy. We also compared the clinical and radiologic and manometric findings of patients according to heartburn symptoms and proton pump inhibitor use.
Results: Our study included a total of 64 patients with a median age of 44.5. The median duration of symptoms was 23.5 months. Sixty-four patients (100%) had dysphagia, 49 (76.6%) had regurgitation, 35 (54.7%) had chest pain, and 38 (59.4%) had heartburn. Typical clinical features of GERD such as regurgitation, heartburn and chest pain were observed in more than 50% of achalasia patients. Proton pump inhibitors were prescribed for 16 patients (25%) on the assumption that they had refractory GERD. Patients with heartburn were more likely to experience weight loss (P = 0.009), regurgitation (P = 0.001), or chest pain (P = 0.019).
Conclusions: Heartburn, regurgitation, and chest pain were commonly observed in patients with untreated achalasia. Patients with heartburn were more likely to experience weight loss regurgitation or chest pain.

PMID: 28351117 [PubMed - as supplied by publisher]

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